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目的:观察2型糖尿病继发慢性肾衰竭患者骨密度减低(包括低骨量和骨质疏松)情况。方法:430例2型糖尿病患者,按照肾功能分为非肾衰竭组和肾衰竭组。采用双能X线骨密度仪测定腰椎正位(L1～4)和股骨部位的骨密度,观察慢性肾衰竭患者骨密度减低情况。结果:与2型糖尿病不伴有明显慢性肾衰竭的患者相比,继发慢性肾衰竭患者[Ccr<60 mL/(min.1.73 m2)]的骨密度减低明显(P<0.01),其骨质疏松患病率为28.3%,男性患者的患病率为19.0%,女性患者的患病率为35.7%。按慢性肾脏病(CKD)分期观察,CKD 3、4、5期患者中,随肾衰竭程度加重,骨密度减低程度逐渐加重(P<0.01或P<0.05)。女性患者的骨密度减低患病率高于男性患者(P<0.01),股骨部位的骨密度减低患病率高于腰椎部位﹙P<0.01)。结论:2型糖尿病继发慢性肾衰竭患者具有较高的骨密度减低患病率。随慢性肾衰竭程度加重,骨密度减低患病率有逐渐增加趋势。
Objective: To observe the reduction of bone mineral density (including low bone mass and osteoporosis) in type 2 diabetic patients with chronic renal failure. Methods: 430 patients with type 2 diabetes mellitus were divided into non-renal failure group and renal failure group according to renal function. Bone mineral density (BMD) in lumbar spine (L1 ~ 4) and femur was measured by dual-energy X-ray absorptiometry. The decrease of BMD in patients with chronic renal failure was observed. RESULTS: Compared with patients with type 2 diabetes who did not have significant chronic renal failure, the bone mineral density (Ccr <60 mL / (min.1.73 m2)] in patients with secondary chronic renal failure decreased significantly (P <0.01) The prevalence of osteoporosis was 28.3%, the prevalence of males was 19.0%, and the prevalence of females was 35.7%. According to chronic kidney disease (CKD) staging, in patients with CKD stages 3, 4, and 5, the severity of renal failure aggravated the decrease of BMD (P <0.01 or P <0.05). The prevalence of decreased BMD in female patients was higher than that in male patients (P <0.01). The prevalence of decreased BMD in femur was higher than that in lumbar (P <0.01). Conclusion: Patients with type 2 diabetes secondary to chronic renal failure have a higher prevalence of reduced bone mineral density. With the exacerbation of chronic renal failure, the prevalence of decreased bone mineral density has gradually increased.